<form id="edit-form" class="form-horizontal" role="form" data-toggle="validator" method="POST" action="">

    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Order_id')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-order_id" data-rule="required" data-source="purchase_order/getOrderInfo" data-multiple="true" data-field="name" data-primary-key="id" class="form-control selectpage" name="row[order_id]" type="hidden" value="{$row.order_id}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Invoice_number')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-invoice_number" data-rule="required" class="form-control" name="row[invoice_number]" type="text" value="{$row.invoice_number|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Invoice_amount')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-invoice_amount" data-rule="required" class="form-control" name="row[invoice_amount]" type="number" value="{$row.invoice_amount|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Create_invoice_time')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-create_invoice_time" data-rule="required" class="form-control datetimepicker" name="row[create_invoice_time]" type="text" value="{$row.create_invoice_time}">
        </div>
    </div>
    <div class="form-group layer-footer">
        <label class="control-label col-xs-12 col-sm-2"></label>
        <div class="col-xs-12 col-sm-8">
            <button type="submit" class="btn btn-primary btn-embossed disabled">{:__('OK')}</button>
            <button type="reset" class="btn btn-default btn-embossed">{:__('Reset')}</button>
        </div>
    </div>
</form>
